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Hum. Reprod. Advance Access published online on August 6, 2004
Human Reproduction, doi:10.1093/humrep/deh451
© 2004 by European Society of Human Reproduction and Embryology
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Received April 22, 2004
Revised June 2, 2004
Accepted July 13, 2004

Article

Embryo loss pattern is predominant in miscarriages with normal chromosome karyotype among women with repeated miscarriage

Mamoru Morikawa 1, Hideto Yamada 1*, Emi H. Kato 1, Shigeki Shimada 1, Takashi Yamada 1, Hisanori Minakami 1

1 Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku N15 W7, Sapporo 060-8638, Japan

* To whom correspondence should be addressed. E-mail: yhideto{at}med.hokudai.ac.jp.


  Abstract

OBJECTIVE: The aim of this study was to assess pregnancy loss patterns in women with repeated miscarriage (RM), according to fetal chromosome karyotypes and aetiologies of RM. METHODS: In this cohort study, 168 fetal chromosome karyotypes of miscarriages were investigated. The pregnancy loss patterns were compared between 75 miscarriages from RM women who had a history of two or more consecutive miscarriages and 93 miscarriages from control women whose previous pregnancies ended in live births without a history of RM. By serial ultrasonography, embryo loss (EL) was defined as miscarriage before fetal heat movement was identified and fetal loss (FL) as miscarriage after fetal heat movement was identified. The EL rate was calculated as EL/(EL+FL). RESULTS: The EL rate (66.7%) in miscarriages with normal karyotypes among RM women (n=42) was higher (P<0.05) than that (45.7%) in controls (n=46), while the EL rate (30.3%) in miscarriages with abnormal karyotypes among RM women (n=33) did not differ from that (25.5%) in the controls (n=47). The EL rate (71.4%) in miscarriages with normal karyotypes among unexplained RM women (n=21) was much higher (P<0.05) than that in the controls. CONCLUSIONS: By evaluating fetal karyotypes, we demonstrated for the first time that EL was predominant in miscarriages with normal karyotype among RM women.

Keywords: chromosome karyotype; embryo loss; recurrent spontaneous abortion; repeated miscarriage; ultrasonography.
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